Hampshire and Isle of Wight Air Ambulance

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This is the first assessment for this service. This key question has been rated outstanding.

This meant service leadership was exceptional and distinctive. Leaders and the service culture they created drove and improved high-quality, person-centred care.

Leaders and staff understood and embodied the culture and values of the workforce and the organisation. They had the skills, experience and credibility to lead the service well and were compassionate and inclusive. Staff felt confident they could speak up and knew how to do this. Staff were given comprehensive training and career development, and managers encouraged research and innovation.

There was a clear system of governance and risk management based around delivering safe and prompt care and treatment. The service worked closely with external partners and stakeholders and was well respected in the local community.

This service scored 96 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 4. The evidence showed an exceptional standard. The service had a very clear shared vision, strategy, and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

Staff said they felt the service respected them and valued their work and there was a strong and shared culture of excellence. Frontline staff described how the senior leadership team had successfully communicated the provider’s vision and values. Non-clinical staff noted although they worked in different areas of the building, there was an open culture with clinical and administrative staff mixing well. Following our inspection, we invited staff to provide feedback regarding the service, and this was overwhelmingly positive in respect to the culture and shared direction.

Staff had the opportunity to contribute to discussions about the strategy for their service, especially where the service was changing. The service was moving to a new headquarters in 2026 which was located in an international airport. Staff were actively involved in discussions on this move and could contribute to giving recommendations on how this new site would look and function. The location of the newer site would support more rapid response deployment and increase opportunities for training and staff development. It would also make it easier for other services to attend for training. In addition to this visitors to the location could also access by public transport.

Staff could explain how they were working to deliver high quality care and there was considerable evidence of this being implemented and making impact to patients.

Leaders provided support to staff throughout their time with the service. Staff understood and had contributed to the organisation's values of ‘teamwork, respect, innovation and compassion’ by doing all they could to support staff and improve patient care. Leaders said they operated an ‘open-door’ policy and staff we spoke with confirmed this. We heard how they felt they could bring any issues directly to leaders and these would be responded to.

Staff described senior managers as visible and approachable. Staff also told us they believed the service helped them to develop their careers, by encouraging training and promotion. Staff confirmed equality, diversity and inclusion was promoted within the workforce. The policy on this guided staff on their work with their patients and wider community. Staff said they could professionally challenge operational decisions and if they had any concerns, there were clear pathways to enable these to be shared with managers.

Staff said they would have no concerns in raising concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences. We heard how any concerns could be raised with duty managers, or senior leaders and staff would feel no hesitation in challenging behaviours within their own service although they had not had to do so.

We scored the service as 4. The evidence showed an exceptional standard. The service had exceptionally inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience, and credibility to lead effectively. They always did so with integrity, openness, and honesty.

Staff said they believed the leaders of the service to be open, honest and understood the challenges faced by the service. All staff spoke warmly of leaders and said the ‘open-door’ policy of the management team encouraged staff to interact with the leadership team and there was a ‘one big team’ feel about the service.

The senior leadership were dedicated, committed and hard working in their roles. This was reinforced by stakeholders who told us ‘We have found the leadership of to be well-qualified, responsive, clear, forward-thinking and kind’.

Leaders had the skills, knowledge and experience to perform their roles. The senior leadership team included staff who also worked operationally. The leadership therefore had up to date and current frontline experience which supported their credibility and integrity. They could explain clearly how the teams were working to provide high quality care. The service offered flexible working for staff, which was welcomed by those with caring responsibilities. It had also set up initiatives to promote wellbeing at work, including promoting psychological counselling, peer discussion, and team events across the year.

The service was exceptionally focused on learning, development and improvement and being at the forefront of observation in patient care. They were highly experienced and well-recognised in their clinical practice for their seniority and credibility.

As staff were routinely exposed to distressing situations as part of their role, senior management worked hard to ensure staff received appropriate psychological support. They offered all staff emotional support and promoted wellbeing as a matter of priority. Leaders told us they would not hesitate to ‘pick up the phone’ and speak to a member of staff who had experienced a distressing situation or appeared in need of support, regardless of if this was work or personal situation. Staff told us how the close-knit environment meant they were acutely aware if a member of the team needed support.

Stakeholders overwhelmingly praised leaders saying they had an exemplary attitude to change and inclusion. Leadership development opportunities were available, including opportunities for staff. The service did not provide any formal training on leadership, but this could be offered by the provider trust if required.

We scored the service as 3. The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff told us there were clear, defined routes for staff to voice concerns about their work or how the service operated. However, staff said if they had concerns which could not take to their line manager, they were free to approach other senior colleagues.The senior leadership team were clearly committed that staff speaking up was incredibly important. They felt the service operated a flat hierarchy where staff of all levels were encouraged to speak up and share.

Should staff feel they could not raise these concerns internally there were also a number of escalated methods for speaking up varied depending on where concerns stemmed from, this included within the NHS Trust who had a well-established ‘Freedom to speak up’ service. They could raise concerns with the NHS ambulance service they partnered with. Staff could also raise concerns with the national guardian’s office and the charity commission if these related to the running of the charity. We heard from staff they had not known of a situation where concerns had needed to be escalated through any means other than internally.

The service also had policies covering wellbeing and dignity at work and a whistleblowing policy. The service did not have their own appointed freedom to speak up guardian but told us that they would review this to establish if it would improve their already well established speaking up methods.

We scored the service as 3. The evidence showed an exceptional standard. The service strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who work for them.

Staff were able to apply to work flexibly for example flexible working agreements to account for personal circumstances such as caring responsibilities and health conditions. There was a trust level policy in place to support staff in requesting career breaks, meaning staff could return to their roles without losing continuity of employment or be unduly penalised for doing so. We saw examples flexible working policies being used to support staff.

Managers undertook risk assessments with staff who were pregnant to ensure they could continue safely in their roles whilst making sure they were not exposed to risks that could harm themselves or their unborn child. Managers also put reasonable adjustments in place for staff members to help them carry out their role.

Leaders had commissioned a service evaluation to look at gender disparity within the service. The aim of this work was to make the service more inclusive to all within the workforce. We reviewed recommendations from this work which showed clear steps that could be taken to address disparity, these recommendations had been welcomed by senior leaders and work was being done to implement them. Leaders also promoted events that helped increase understanding around disabilities and neurodivergent conditions.

University Hospital Southampton NHS Foundation Trust undertook equality monitoring of staff within the service to ensure it is diverse in its make-up and representative of the patient group. There was a provider level equality, diversity and inclusion (EDI) policy which outlined the goals and objectives for the trust. There was also an EDI calendar with listings events that staff could attend and participate in. This included speakers for black history month, pride month and social injustice.

We scored the service as 4. The evidence showed an exceptional standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment, and support. They always act on the best information about risk, performance, and outcomes, and share this securely with others when appropriate.

The service had a clear governance framework and regularly reported to its board of trustees. It also provided information and reports to external bodies, including the CQC, the Charities Commission and Civil Aviation Authority. The service provided feedback and shared information with external clinical forums to ensure it kept up to date with best clinical practice. Internally, there were specific workstreams set up to lead research, education, and innovation, and clinical safety. There was a clear and committed strategy around governance and risk management.

Leaders and staff agreed how funding for the charity and moving to a new site were the main risks to the service. When we spoke to staff about risk their concerns matched those on the risk register. Where cost improvements were taking place, they did not compromise patient care.

Managers told us they had good and well-established links with external stakeholders and used internal and external systems to measure quality of performance. This included quarterly review meetings as well as joint education and training.

The implementation of reviewing every case meant oversight of care was maximised. All of this was intended to share excellent practice and where things could have been managed better. It was also key to the senior staff to understand how the patient was treated throughout and keep them at the centre of care and treatment decisions.

Leaders acted on the best information to ensure it understood its risks, performance and outcomes. They managed performance well and there was a proactive approach to managing risk which allowed new and innovative ideas to be tested and well researched.

There was a clear agenda for team meetings to ensure essential information, such as learning from incidents and complaints, was shared and discussed. Staff had implemented recommendations from reviews of deaths, incidents and complaints. It also shared all relevant learning with stakeholders to ensure learning was wide reaching.

Staff undertook or participated in local clinical audits such as call handling communication, anaphylaxis, and chest pain attendances The outcome of audits was discussed in dedicated clinical audit review group meetings and in leadership meetings to ensure and risks and actions from audit were communicated. The audits were sufficient to provide assurance and staff acted on the results when needed.

The service had plans for emergencies such as major incidents, adverse weather conditions, and staff shortages.

We scored the service as 4. The evidence showed an exceptional standard. The service clearly understood and carried out their duty to collaborate and work in partnership, and services worked seamlessly for people. They always share information and learning with partners and collaborate for improvement.

Stakeholders for the service provided feedback which praised it for its commitment to patient care and outcomes. We heard how they valued their working relationships, and these had flourished in recent years. Staff told us how they were keen to continually improve working relationships with ambulance service staff who they worked alongside to provide patient care. Examples of this included attending ambulance bases to provide training where they provided refreshments and skills updates.

The service worked with national groups such as the helicopter emergency medicine group. They also held multi agency training that was attended by other emergency services and ambulance staff from other organisations. The service liaised with the local integrated care board to highlight areas of improvement they had identified. Staff from the services were represented in regional trauma networks. They were also strategically and clinically represented by the service with representation at both local NHS ambulance trusts.

There were multiple community engagement events the service attended such as family days, emergency service vehicle events and festivals. Often this work was led by the charitable arm of the service to raise much needed funds, but the community welcomed this presence. It increased the profile of the staff and their work and also gave younger children and families an opportunity to hear about the service. The website for the service had details of multiple events that the public could attend to raise funds and increase community profile. The service also offered support to members of the public who were bystanders to traumatic incidents through their after care service.

We scored the service as 4. The evidence showed an exceptional standard. The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome, and quality of life for people. They actively contribute to safe, effective practice and research.

There was an exceptional focus on learning, improvement and innovation. This was at the forefront of this service and centred on delivering the best patient care. Learning included both learning from every interaction of care, but also a clear long-term focus on development and innovation.

Staff had attended various UK and international events where they shared learning from these initiatives with other helicopter emergency medical services. Innovations were taking place in the service. Published research from the past 12 months included:

• Cardiac Arrest Bundle of cARE Trial (CABARET) which looked at the benefits of using a variety of methods to improve blood flow to the brain during CPR such as Head-Up CPR.
• REVIVE 1 2 a study on the long-term cognitive impact on patients who suffer out of hospital cardiac arrest.
• A study comparing the benefits of video laryngoscopy versus direct laryngoscopy in a UK pre- emergency medical service

Staff told us they were also applying for many other research studies including, but not limited to, an Adrenaline Infusion Feasibility Study, and further research under the REVIVE programme, Statistical analysis on Air Pollution and Cardiac Arrest Outcomes.

Staff were given the time and support to develop opportunities for improvements and innovation and this led to changes in care delivery. There was a dedicated commitment to not only contributing to research but were actively leading it. The service website showed numerous published research papers that staff from the service were not only involved in but also authored. Staff spoke proudly about the research accomplishments and said how everything they did was for the direct benefit of patient.

The service had identified risks around a lack of formal governance structure for research, in response to this they had identified the need for a structured research and audit framework in line with Trust and national best practice. They had implemented a dedicated research workstream which reported directly to the Senior Leadership Team. All ongoing and planned projects were registered under the UHS electronic risk and incident management system, ensuring full audit trails and compliance with local governance processes. Senior leaders received monthly research updates in dedicated meetings. The service had also implemented a journal club to support staff with continual professional development, and reviewing emerging research.

Staff were supported to prioritise time for developing their skills and abilities. Clinical staff attended debrief meetings for every patient, this was to analyse actions and consider outcomes to help learning. There were also notice boards around the base with updated information. The service had clear pathways and supervision arrangements to enable the ongoing development for doctors. Paramedics also had a development plan to ensure they had the skills to provide safe pre-hospital critical care.

Staff were encouraged to make suggestions for improvements in processes, and these could be reviewed and acted on by leaders. This meant staff had a clear route to develop research ideas, which were supported by mentorship and a robust approval process. Leaders told us that benefits they had seen from this work included improved staff engagement, stronger collaboration with other organisations. This also showed a commitment to continual learning and innovation.